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World Journal of Clinical Cases 2022年第11期10卷 3593-3600页

作者： Hang-Ping Wei Jie Mao Zu-Liang Hu Department of Medical Oncology Dongyang Hospital Affiliated to Wenzhou Medical UniversityDongyang 322100Zhejiang ProvinceChina Department of Radiology Dongyang Hospital Affiliated to Wenzhou Medical UniversityDongyang 322100Zhejiang ProvinceChina

BACKGROUND Apatinib is an orally bioavailable small-molecule receptor tyrosine kinase *** December 2014,the China Food and Drug Administration made it the first anti-angiogenic therapy to be approved for treating metastatic gastric *** was specifically designated as a third-line or later treatment for metastatic gastric *** SUMMARY Here,we present a case of advanced renal cell carcinoma(RCC)with multiple metastases(Stage IV)in a 48-year-old male with an extremely poor general status(Karnofsky 30%).He was initially given pazopanib as a targeted ***,he experienced severe adverse reactions within two weeks,including grade IV oral ***,thus,tried switching his targeted treatment to an apatinib dose of 250 mg once daily since April *** patient demonstrated striking benefits from this switch to the apatinib palliative *** one month later,his pain and other associated symptoms were *** patient was able to move freely and had an excellent general status(Karnofsky 90%).His progress has been followed up with regularly,allowing for a documented progression-free survival interval of approximately 32 *** This case suggests that,like other multi-target drugs,apatinib may be a useful first-line therapeutic drug for advanced *** may be a particularly helpful curative option when patients are found to be intolerant of other targeted drugs.

关键词： Apatinib Renal cell carcinoma Targeted therapy palliative treatment Case repor

palliative treatment of Locally Advanced Non Metastatic Lung Cancer

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Journal of Cancer Therapy 2021年第2期12卷 71-77页

作者： Gael Kietga Wilfried Mosse Patricia Agbanglanon Bertrand Compaore Davy Nchepo Evrard Seka Sanae Elmajjaoui Hanane Elkacemi Tayeb Kebdani Amine Lachgar Noureddine Benjaafar Radiotherapy Department National Institute of Oncology Rabat Morocco

Introduction: To determine the proportion and the reasons which lead to palliative treatment in patients initially a candidate for concomitant chemoradiotherapy (CCRT). Methods: A retrospective study including patients followed for locally advanced lung cancer newly diagnosed from April 1, 2016, to 12/31/2017 in the radiotherapy department of the National Oncology Institute who received palliative treatment. Results: We collected 52 patients out of a total of 225 stage III patients (23%) followed by lung cancer candidates for CCRT who had undergone palliative treatment. The mean age in our series was 61.23 years [22 - 81] with 86% male. The majority of patients (71%) had Performance Status (PS) ≤ 2. Histological confirmation was obtained by pathological examination in all our patients. It was an adenocarcinoma (ADK) in 54% of cases;squamous cell carcinoma in 46% of cases. The reasons for palliative treatment were mainly due to dosimetric constraints: large tumor volume 22/52 (42%);the tumor location close to the bone marrow in 15 of 52 (29%) patients;and general Performance Status impairment (29%) in 15 of 52 patients. Palliative treatment consisted of palliative chemotherapy in 37 of 52 patients (71%),

Clinical observation of continuously subcutaneous-pumped octreotide infusion in palliative treatment of malignant bowel obstruction

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The Chinese-German Journal of Clinical Oncology 2011年第1期10卷 31-34页

作者： Dongfeng Yin Yin Zhu Yuqing Xing Hong Gao Yuzhen Pan Lin Pan Guangyi Tang Xiangrong Xing Lijiang Zhou Department of Internal Oncology Affiliated Hospital of Liaoning University of Traditional ChineseMedicine Shenyang 110032 China

Objective： The aim of the study was to observe the effectiveness of continuously subcutaneous-pumped octreotide infusion in palliative treatment of malignant bowel obstruction （MBO）. Methods： Clinical data were retrospectively analyzed in 26 carcinoma patients complicated with MBO, in the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, China, from March 2007 to April 2009. All 26 carcinoma patients with MBO were divided into no groups： the controlling group （CG, routine therapy, 15 patients） and the octreotide group （OG, 11 patients）. The octreotide group received routine therapy combined with octreotide （0.3 mg/d） by 24 hours continuously subcutaneous octreotide infusion. The changes of curative effectiveness related to symptoms, the times of recovering exsufflation and defecation, the average drain of gastrointestinal drainage tube, the duration of gastrointestinal drainage tube and the rate of extubation, were observed and compared between the two groups. Results： After treatment, remarkable changing rates of MBO related symptoms were 81.8% （9/11） in OG, and 46.7% （7/15） in CG （P 〈 0.05）. The 78% of SG and 30% of CG recovered the exsufflation and defecation, and the mean times they needed were 3.2 d and 5.8 d, respectively （P 〈 0.05）. The durations of gastrointestinal drainage tube of OG and CG were （5 ± 1.2） d and （10 ±2.3） d, respectively, and the rates of extubation were 54.5% and 20%, respectively. The improvement rate in the octreotide group was better than that in the controlling group and the difference was significant （72.7% and 26.7%, P 〈 0.05）. Conclusion; The administration of octreotide in combination with routine treatment can be very effective in the treatment of MBO. It can relieve the symptoms of MBO effectively and improve the quality of life of the end-stage patients. It has provided one kind of new treating thought and method for treatment of malignant bowel obstruction.

关键词： malignant bowel obstruction (MBO) octreotide palliative treatment continuously subcutaneous-pumped infusion

Organ and function preservation in gastrointestinal cancer: Current and future perspectives on endoscopic ablation

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World Journal of Gastrointestinal Endoscopy 2024年第6期16卷 282-291页

作者： Youssef Yousry Soliman Megan Soliman Shravani Reddy James Lin Toufic Kachaamy Department of Gastroenterology City of Hope PhoenixGoodyearAZ 85338United States Department of Medicine Medical ConsultingGoodyearAZ 85395United States Department of Gastroenterology University of California IrvineIrvineCA 92697United States Department of Gastroenterology City of Hope National Medical CenterDuarteCA 91010United States

The escalating prevalence of gastrointestinal cancers underscores the urgency for transformative *** treatment costs amount to billions of dollars annually,combined with the risks and comorbidities associated with invasive *** highlights the importance of less invasive alternatives with organ preservation being a central aspect of the treatment *** current standard of care typically involves neoadjuvant systemic therapy followed by surgical *** is a growing interest in organ preservation approaches by way of minimizing extensive surgical *** ablation has proven to be useful in precursor lesions,as well as in palliative cases of unrese-ctable *** recently,there has been an increase in reports on the utility of adjunct endoscopic ablative techniques for downstaging disease as well as contributing to non-surgical complete clinical *** expansive field within endoscopic oncology holds great potential for advancing patient *** addressing challenges,fostering collaboration,and embracing technological advancements,the gastrointestinal cancer treatment paradigm can shift towards a more sustainable and patient-centric future emphasizing organ and function *** editorial examines the evolving landscape of endoscopic ablation strategies,emphasizing their potential to improve patient *** briefly review current applications of endoscopic ablation in the esophagus,stomach,duodenum,pancreas,bile ducts,and colon.

关键词： Gastrointestinal cancer Endoscopic ablation Organ preservation Complete clinical response Neoadjuvant therapy Endoscopic oncology palliative treatment

Results of Surgical Management of Malignant Obstruction of the Common Bile Duct in Yaoundé

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Surgical Science 2024年第4期15卷 265-277页

作者： Eric Patrick Savom Gaël Tsanga Nomo Richard II Mbele Mahamat Yannick Ekani Boukar Cédric Paterson Atangana Fred Dikongue Dikongue Guy Aristide Bang Arthur Essomba Yaoundé General Hospital Yaound&#233 Cameroon Faculty of Medicine and Biomedical Sciences of the Universityof Yaoundé I Yaound&#233 Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences of the University of Dschang Dschang Cameroon Yaoundé Teaching Hospital Yaound&#233 Cameroon

Introduction: In Cameroon, surgery remains the only approach in malignant obstructions of the common bile duct (MOCBD) even in palliative situations. The aim of this work was to describe the modalities of surgical treatment of MOCBD, evaluate the results and detect the factors associated with postoperative morbidity and mortality. Patients and Methods: We conducted an analytical observational study, with retrospective data collection from the files of patients operated upon for MOCBD. This was done in four referral hospitals in the city of Yaoundé for a 42-month period spanning from January 1, 2020 to June 30, 2023. Demographic data, clinical presentation, surgical data, and 30-day postoperative outcomes were collected. Results: We collected 71 files. The sex ratio was 1.4 and the mean age was 56 ± 11 years. Fifty-three (53) patients (74.6%) were overweight or obese and 10 patients (14.1%) were hypertensive. A clinical cholestasis syndrome was present in 69 patients (97.2%). Fifty-five (55) patients (77.5%) had a cancer of the head of the pancreas, 8 patients (11.3%) had an extra-hepatic cholangiocarcinoma and 8 patients (11.3%) had an ampullary adenocarcinoma. Eight (8) resections (11.3%) with curative intent had been carried out and in 63 cases (88.7%), surgery was palliative. Postoperative morbidity was 55.7%, influenced by advanced WHO stage (p = 0.02). Postoperative mortality was 25.7%, associated with a high ASA score (p = 0.01). Conclusion: Pancreatic head cancer is the main etiology of malignant obstructions of the common bile duct in Cameroon. Surgical treatment is most often palliative. Postoperative morbidity and mortality are high, influenced by high WHO and ASA scores.

关键词： Malignant Obstruction Common Bile Duct palliative treatment Morbidity Mortality

Transarterial chemoembolization as initial treatment for unresectable hepatocellular carcinoma in southern China

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World Journal of Gastroenterology 2010年第2期16卷 264-269页

作者： Shi, Ming Chen, Ji-An Lin, Xiao-Jun Guo, Rong-Ping Yuan, Yun-Fei Chen, Min-Shan Zhang, Ya-Qi Li, Jin-Qing Sun Yat Sen Univ Dept Hepatobiliary Ctr Canc Guangzhou 510060 Guangdong Peoples R China

AIM:To identify prognostic factors from pretreatment variables of the initial transarterial chemoembolization(TACE)procedure in unresectable hepatocellular carcinoma(HCC). METHODS:One thousand and five hundred and sixtynine patients with unresectable HCC underwent TACE as initial treatment were retrospectively *** variables of the initial TACE procedure with a P value less than 0.05 by univariate analysis were subjected to Cox proportional hazards model. RESULTS:The median overall survival time and 1-, 5-,10-year survival rates were 10.37 mo,47%,10%, and 7%,respectively.A Cox proportional hazard model showed that 8 pretreatment factors of regional lymphnodes metastasis,Child-Pugh class,macrovascular invasion,greatest dimension,α-fetoprotein(AFP), Hepatitis virus B,tumor capsule,and nodules were independent prognostic *** with multimodality therapy have better survival than those with TACE treatment only. CONCLUSION:Tumor status,hepatic function reserve,AFP,and hepatitis virus B status were independent prognostic factors for unresectable *** metastasis might not be a contraindication to TACE. Multimodality therapy might improve survival.

关键词： Hepatocellular carcinoma Transarterial chemoembolization palliative treatment Prognosis

Current therapy of hilar cholangiocarcinoma

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Hepatobiliary & Pancreatic Diseases International 2012年第1期11卷 12-17页

作者： Stephanie Hiu Yan Lau Wan Yee Lau Faculty of Medicine The Chinese University of Hong Kong

BACKGROUND: Hilar cholangiocarcinoma (HC) is an adeno-carcinoma of the extrahepatic biliary tree arising from the main left or right hepatic ducts or their confluence. This tumor is still considered to be difficult to treat or to cure. DATA SOURCES: We reviewed the medical literature on HC. Relevant and updated information on this tumor was analyzed in a concise and easy-to-read manner. The article is not intended to be a systematic review, but an extensive search was conducted on PubMed and MEDLINE using the keywords 'hilar cholangiocarcinoma' and 'Klatskin tumor' until July 2011. RESULTS: The selection and the timing of management options for patients with HC are determined by the degree of certainty of the diagnosis, the general condition of the patients, the underlying liver function and the stage of the disease. Current treatment of HC can be divided into curative and palliative treatment. For the curative treatment, local excision should only be used on small tumors which are confined to the bile duct wall and Bismuth I papillary carcinoma. Partial hepatectomy should be combined with caudate lobe resection and porta-hepatis lymph node dissection. The results of these major resections can be improved with portal vein embolization, and staging laparoscopy and laparoscopic ultrasound. The role of preoperative biliary drainage is controversial. Autotransplantation for HC gave disappointing results while the Mayo Protocol of chemoradiation for selecting patients with unresectable HC for orthotopic liver transplantation has been widely accepted. palliative treatment included bypass surgery, endoscopic or percutaneous stenting, photodynamic therapy, intraluminal brachytherapy, and external radiation and systemic therapy. CONCLUSIONS: Adequate surgery with R0 resection should be the main goal of treatment. For patients with unresectable HC, treatment aims to improve the quality and quantity of their survival.

关键词： hilar cholangiocarcinoma Klatskin tumor resection liver transplantation palliative treatment

Stevens-Johnson syndrome and concurrent hand foot syndrome during treatment with capecitabine:A case report

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World Journal of Clinical Cases 2021年第17期9卷 4279-4284页

作者： Ha Rim Ahn Sang-Kyung Lee Hyun Jo Youn Seok-Kweon Yun Il-Jae Lee Division of Breast and Thyroid Surgery Department of SurgeryJeonbuk National UniversityJeonju 54907South Korea Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital Jeonju 54907South Korea Department of Dermatology Jeonbuk National University Medical SchoolJeonju 54907South Korea

BACKGROUND Capecitabine is used in combination with lapatinib as palliative treatment for human epidermal growth factor receptor 2-positive metastatic breast *** most frequently reported adverse events attributed to capecitabine include diarrhea,hyperbilirubinemia,and hand-foot syndrome(HFS).A number of cutaneous adverse events have been attributed to capecitabine,including Stevens-Johnson syndrome(SJS)as a rare and potentially life-threatening mucocutaneous *** report the first case involving concurrent SJS and HFS after capecitabine and lapatinib *** SUMMARY A 70-year-old woman with a history of breast cancer treatment visited our hospital for evaluation of painful skin *** weeks earlier,she had been prescribed capecitabine plus lapatinib as treatment for metastatic breast *** subsequently developed worsening erythema and bullae on her palms and soles,as well as reddish macules on her back and chest *** evaluation of the chest wall lesions revealed extensive eosinophilic epidermal necrosis and separation of the epidermis from the *** capecitabine plus lapatinib treatment was discontinued immediately and treatment was started using systemic *** treatment resolved most lesions,although the lesions on her palms and soles required Vaseline gauze dressings,which resulted in ***,we determined that the patient had concurrent SJS and *** the dermatological problems resolved,the patient ultimately died because of multiple organ *** Oral capecitabine treatment carries a risk of both HFS and also life-threatening adverse cutaneous drug reactions,such as SJS.

关键词： Stevens-Johnson syndrome Hand-Foot syndrome palliative treatment Capecitabine Breast neoplasms Case report

palliative Endoscopic Therapy for Cancer Patients with Esophageal Fistula

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Chinese Journal of Cancer Research 2008年第1期20卷 53-56页

作者：张集昌张力建吴齐张军周宗慧吴洋徐肇丽 Department of Endoscopy Peking University School of OncologyBeijing Cancer HospitalBeijing Institute for Cancer Research Department of Thoracic Surgery Peking University School of OncologyBeijing Cancer HospitalBeijing Institute for Cancer ResearchBeijing 100036

Objective： To find an effective treatment for advanced cancer patients with esophageal fistula. Methods： From 1998 to 2006, we studied 42 patients with advanced esophageal cancer and 5 lung cancer patients with carcinomatous esophageal fistula （3 females, 44 males, aged 29-92 years）. Ten patients with both esophageal cancer stricture and fistula were first dilated under endoscope, then a memory stent with a membrane was placed in the esophageal lumen. Others were treated only with a memory stent with a membrane, three of them with a large fistula （diameter 〉1.5 cm） were treated with bio-protein glue after placement of an esophageal metal stent. Results： The fistulas were covered by a stent and the patients could eat and drink immediately. Their quality of life was improved and their survival was prolonged, 44 out of 47 patients survived for 〉3 mo. Conclusion： Placement of esophageal stent with membrane or in combination with bio-protein glue through endoscope is an effective method for treating the bronchoesophageal fistula.

关键词： Esophageal fistula Endoscopic treatment palliative treatment

Complete hepatocellular carcinoma necrosis following sequential porto-arterial embolization

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World Journal of Gastroenterology 2008年第44期14卷 6869-6872页

作者： Stéphane Zalinski Olivier Scatton Bruto Randone Olivier Vignaux Bertrand Dousset Department of Surgery Cochin HospitalAssistance Publique-Hpitaux de ParisUniversité DescartesParisFrance Department of Radiology Cochin HospitalAssistance Publique-Hpitaux de ParisUniversité DescartesParisFrance

Most patients with hepatocellular carcinoma （HCC） are not eligible for curative treatment, which is resection or transplantation. Two recent series have emphasized the potential benefits of preoperative arterio-portal embolization prior to surgical resection of such tumours. This preoperative strategy offers a better disease free survival rate and a higher rate of total tumor necrosis. In case of non resectable HCC it is now widely accepted that transarterial chemoembolization （TACE） leads to a better survival when compared to conservative treatment. Thus, the question remains whether combined portal vein embolization （PVE） may enhance the proven efficiency of TACE in patients with unresectable HCC. We herein report the case of a 56-year-old cirrhotic woman with a voluminous HCC unsuitable for surgical resection. Yet, complete turnout necrosis and prolonged survival could be achieved a^er a combined porto-arterial embolization. This case emphasizes the potential synergistic effect of a combined arterio-portal embolization and the hypothetical survival benefit of such a procedure, in selected patients, with HCC not suitable for surgery or local ablative therapy.

关键词： Hepatocellular carcinoma Sequentialarterio-portal embolization palliative treatment